If Cary is close to home, she cranks up her wheelchair and heads for her apartment. If not, she tightens her seat belt because the 100-pound bullmastiff mongrel she picked at the city animal shelter as a companion dog seems to know when she is about to have a seizure.

Sebastian is one of dozens of animals in Greater Sacramento that help their owners live independent lives despite disabilities, provide comfort during pain or spark memories in the haze of an Alzheimer's patient's mind. Some are professionally trained, while others are personal pets with sunny dispositions owned by people willing to spend some time helping others.

It costs $38,000 or more to train a guide dog for the blind and teach the dog owner how to use the animal, but Guide Dogs of America is funded by voluntary contributions and provides the animals for free to blind or visually impaired men and women.

Most therapy pets that visit patients in hospitals, nursing homes or private residences are trained by nonprofit organizations and managed by volunteers.

"It's mostly a grassroots activity that provides an opportunity to spend time with your own pet and give back to the community," said David Frei, a spokesman for the Delta Society, a Bellevue, Wash.-based nonprofit service organization that connects Americans with mental and physical illnesses and disabilities with professionally trained service dogs and therapy animals.

The organization has more than 10,000 pet-partner teams that visit more than 3,000 healthcare facilities, schools, libraries and other places annually, Frei said.

Most of the pets are dogs or cats, but guinea pigs, rabbits, horses, goats, llamas, donkeys, parrots and potbellied pigs are put into action because they touch humans in ways other humans can't.

Medication costs dropped more than $2 per patient per day in new nursing homes in New York, Missouri and Texas that have animals and plants as an integral part of the environment.

Blood pressure and production of the stress hormone epinephrine dropped significantly in cardiac patients after a dog visited for just 12 minutes, the American Heart Association reports.

No one knows for sure how dogs such as Sebastian can sense a seizure coming on, but researchers suggest subtle changes in smell may alert them. Sebastian whines, paws his owner and shows other signs of distress 15 to 45 minutes before Cary begins to black out, a condition she attributes to a brain injury when she was 11.

He's never been wrong.

EMPATHY AND DISTRACTION

Tension in the pain management clinic at Kaiser Permanente's South Sacramento Medical Center drops the minute Phoebe walks into the room, said Laura Dammel, a physical therapist who runs the clinic and owns the 5-year-old English springer spaniel.

The program teaches patients suffering from chronic pain how to cope and live a healthier, more active life.

"Dogs know when a person is feeling down and hurting," said Patricia Garcia, 50. She suffers from scoliosis, has steel implants in her back and is learning how to work muscles she hasn't used in a while. "Having her in class really lifts my spirits."

Shannon Raymond, 35, suffers from back and neck problems from a car accident. Phoebe is a welcome distraction to pain and reinforces the fact that Raymond's dogs at home can be a comfort for her, too.

"In the Pilates class, a lot of us -- particularly those of us with back pain -- struggle with our stomach muscles," Raymond said. "Phoebe will come up and put her head in my lap."

'WE'VE ALL EXPERIENCED MIRACLES'

Realtor Pamela Tobin is a woman of many hats; one of them is to test therapy dogs.

"There is more demand than I have dogs for, and I just graduated a class of 10," said Tobin. "It's not just a matter of taking Fluffy into a facility."

The pet must have a relaxed temperament and be obedient. Owners must know their animals and clues that suggest they are tired. But when it all works, Tobin said, the results can be dramatic.

"I've watched the color come back into patients' cheeks," she said. "Or an Alzheimer's patient will be almost catatonic until an animal is able to reach behind, somewhere inside in their mind -- to the memory of a pet, perhaps -- and they come back for a little while."

Robert Beard, 83, perked up last week when a teacup poodle mix named Lily was placed on his lap. The Source of Unconditional Love (SOUL) program run by Mercy Hospice visits hospice patients in their homes, any of the local Mercy hospitals or other facilities free of charge.

"He loves animals; he wanted at one time to be a vet but ended up in the dairy industry instead," said Anne Beard, his wife. "These visits make him more relaxed and content, just like an old friend came to visit, even though sometimes they both doze off."

At 4 pounds and a well-groomed white frizz, Lily gets a bath before the visit, her teeth cleaned and nails clipped. Hospice patients' skin can be papery thin.

"We've all experienced a few miracles," said Debra Fujita, a registered nurse with the SOUL program.

A hospital patient with a brain tumor, unable to speak, Fujita recalled, was talking full sentences by the end of a visit with Lily.

'SHE DOESN'T CARE'

For some, the unconditional acceptance animals give humans -- regardless of what they look like or what they've done -- is healing in itself.

It's Bunny Day on the first Monday of every month in the outpatient clinic at Shriners Hospital for Children in Sacramento. Tuesday is Rotweiller Day, but as many as 20 teams of dogs, cats, bunnies and their owners take turns roaming the place.

"Some really nice things happen when they do," said Cathy Bones, a Delta Society member who runs the program.

A child missing bones in his arms so his hands are where his elbows should be was greeted at the clinic by a basset hound, who rolled over and looked up expectantly, Bone said.

"The child gave me a wonderful look and said, 'She doesn't care about my arms?'"